The relation between the working alliance on mental illness and criminal thinking among justice-involved people with co-occurring mental illness and substance use disorders.

Abstract

Objective: The therapeutic working alliance is an important factor in producing treatment change and positive therapeutic outcomes for people with mental illness, yet little is known about the working alliance's role in treatment change in people with mental illness that is justice involved. In addition to treating the mental illness symptoms of justice-involved people with mental illness, addressing factors known to predict criminal behavior (including criminal thinking) could optimize posttreatment outcomes and reduce future justice involvement. This study examines the role of the working alliance in treatment change in a clinical treatment sample of 265 adult male and female justice-involved people with mental illness and substance use disorders completing probation sentences in a residential treatment facility. Method: Repeated measures moderation analyses were used to test participants' reported working alliance as a moderator of change from pre-to posttreatment scores of self-reported mental illness symptoms and criminal thinking. Results: The working alliance significantly moderated reductions in depression, anxiety, anger, and manic symptoms (R 2 ranging from .03 to .09), and general, reactive, and current criminal thinking (R 2 ranging from .04 to .11). Conclusions: These findings expand the literature on the relation between working alliance and changes in mental illness symptoms by testing this association in the understudied population of justice-involved people with mental illness; these results also suggest the working alliance is associated with changes in criminal thinking. Treatment providers working with justice-involved people with mental illness should assess and emphasize the development of a working alliance to maximize treatment change.What is the public health significance of this article? These findings expand our understanding of the role of the working alliance in treatment change among a criminal justice-involved clinical sample with mental illness and substance use disorders. Clinicians should continue to focus on not only treatment needs but also treatment processes for people with mental illness, regardless of setting.

Tried and True? A Psychometric Evaluation of the Psychological Inventory of Criminal Thinking Styles-Short Form

“…Results of Study 1 suggest the PICTS-SF offers a reliable and structurally consistent method for assessing criminal thinking. Using two measures of internal consistency, the current study’s evidence of the PICTS-SF’s reliability is consistent with reliabilities found in previous studies using the PICTS-SF (Batastini et al, 2019, 2020; Scanlon et al, 2022; Varghese et al, 2018). As hypothesized, the PICTS-SF GCT, PCT, and RCT subscales demonstrated discriminant validity with the MCAA Attitudes toward Violence and Antisocial Intent subscales, per significant, positive and moderate correlations.…”

“…In Studies 1 and 2, we found evidence of the 35-item version of the PICTS-SF's internal consistency reliability, using both alpha and omega estimates, similar to that found in previous studies (Batastini et al, 2019(Batastini et al, , 2020Gaspar et al, 2019;Scanlon et al, 2022;Varghese et al, 2018). We also found evidence for discriminant validity with two measures of the similar but distinct construct of antisocial attitudes: the MCAA and CSS-M.…”

“…Similarly, ordinal omega estimates in all five imputed datasets (ω = .96, 95% CI = .95, .96) demonstrated identically strong reliability in the current sample. These internal consistency estimates are roughly consistent with prior reliabilities of the PICTS-SF (α = .94, Batastini et al, 2019; α = .91, Batastini et al, 2020; α = .94, Scanlon et al, 2022; α = .91, Varghese et al, 2018) and the PICTS-L-SF GCT (ω = .96, Mitchell et al, 2017). The average inter-item correlation for the PICTS-SF GCT (Spearman’s ρ = .30, 95% CI = .27, .34), PCT (ρ = .30, 95% CI = .26, .33), and RCT (ρ = .39, 95% CI = .35, .41) items were also acceptable.…”

“…Given the PICTS-SF's use in correctional research (Batastini et al, 2019(Batastini et al, , 2020Gaspar et al, 2019;Scanlon et al, 2022;Varghese et al, 2018;Walters, 2009), the current studies evaluated the following psychometric properties of the PICTS-SF: (1) reliability, (2) structural validity, (3) discriminant validity, and (4) postdictive validity. The purpose of Study 1 was to provide preliminary evidence of the PICTS-SF's internal consistency reliability, and structural and discriminant validities.…”

The association between counselor ratings of working alliance and in‐session empathy among sex offender counselors

“…Although there is no direct evidence connecting working alliance with reduced recidivism rates in sex offender counseling, the reasoning that these factors are connected is based on the strong connections between working alliance and client outcomes in non‐offender counseling. Moreover, recent empirical data has highlighted the importance of empathy and therapeutic alliance in sex offender counseling from the perspective of sex offender counselors (Carrola, 2022), and more broad research on offender counseling has shown the impact of working alliance in reducing both criminal thinking and mental illness symptoms in justice‐involved clients (Scanlon et al., 2022).…”